Communication Skills Competency 1.1

Competency 1.1 – Overarching competency: The ability to take an accurate history from patients with a range of optometric conditions

This competency does what it says on the tin.  To pass this the Assessor needs to witness via a variety of methods that an accurate, relevant history can be taken and recorded from a number of patients with history of different eye conditions.

Best Form Evidence

Most Assessors will witness one full routine during the first assessment, so the primary method of assessment will be Direct Observation of accurate history taking, on a patient.  It is prudent therefore to try and engineer a patient with some “history” or this competency may not be ticked off via this method of evidence.

As with all competencies one piece of evidence is not enough, so an Assessor will probably also look at and discuss a selection of Patient Records, the Logbook and possibly conduct a case scenario or role play.

Note: the competency states “accurate history” so if there is “no history” then the competency cannot be signed off.

Note: the competency states “range of optometric conditions”.  Therefore one patient episode alone will not achieve this competency. The Assessor will then need to observe supplementary forms of evidence to achieve sign off.  The easiest ways are by looking at patient records or by the Assessor creating a case scenario for a fictitious patient maybe in a “role-play” style.  They may provide an “incorrect” record to criticise.

When taking an accurate history, the trainee should remember to cover all relevant history.  If a positive (or sometimes negative!) response is attained then the trainee must consider the need to follow-up with further appropriate questions.

Points to cover include:

Previous eye exam

When, where, any dispense (incl C.L)

Contact Lenses

When, where, how long, current type, previous types, modality, compliance,                    solutions, last aftercare

Any previous/current spectacles

Type, tasks worn for, any adaptation

Condition, age

Any previous visits to doctor/HES/orthoptist

Why, when, treatment received, outcome

Ongoing, next visit, last visit

Any history as a child (if not covered in question above)

Note: Family history is a separate competency that has some overlap with this one.

The Assessor will look for appropriate questioning, sensible structured list of open/closed/leading questions and appropriate follow up.

As the competency clearly states “range of optometric conditions” so the Assessor will expect evidence from a “range of conditions” e.g. with orthoptic history, previous laser surgery, corneal infection, spectacles etc

An example from a record may look like this:

LEE 12/12 Hogwarts branch (records requested), has worn DV specs only since 8 years old, full time. Current gls 12/12, good condition. No C/L wear.

Hairbrush in right eye 24/12 ago, went to Gryffindor HES, given bandage contact lens for 2/52 with antibiotics, then discharged, not aware of any probs. No other problems as adult or child.

Unacceptable Evidence

Reasons for failing this competency basically revolve around not asking any history, enough history or following up history. Or not writing it down!

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